Third Party Verification Specialist

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

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Role Overview: The Third Party Liability (TPL) Verification Specialist plays a critical role in ensuring the company remains the payer of last resort by accurately identifying, validating, and maintaining plan member TPL information across all lines of business.

Work Arrangements:

• Remote - Associate can be located anywhere in the United States.

Responsibilities:

• Investigate, verify, and update Plan Member TPL information for all Lines of Business.

• Communicate findings to state agencies, vendors, and internal and external departments as required.

• Review state and vendor disposition reports to determine when manual entry or data updates are necessary.

• Accurately navigate, document, and maintain information within the healthcare system.

• Research Plan Members' other insurance coverage using online resources and direct outreach to insurance carriers.

• Ensure data accuracy and compliance with payer-of-last-resort requirements.

Education & Experience:

• High School Diploma or GED required; Associate's Degree preferred.

• 1 to 3 years of experience with data entry, insurance verification, or healthcare operations is strongly preferred.

Skills & Abilities:

• Strong data entry and documentation skills with a high level of accuracy.

• Proficiency in Microsoft Office applications.

• Ability to effectively investigate and analyze insurance coverage information.

• Strong communication skills for interacting with insurers, vendors, and internal stakeholders.

• Detail-oriented with the ability to manage and interpret reports and system data efficiently.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.